Morphine is part of a class of drugs called opiate (narcotic) analgesics, or opioid agonists, which block the transmission of pain signals to the brain by binding to nervous system proteins called opioid receptors.
Morphine is also sometimes prescribed “off label” to treat pain in hospitalized children.
The Food and Drug Administration (FDA) first approved morphine in 1941. Multiple companies, including King Pharmaceuticals, Hospria, and Roxane Laboratories, manufacture the drug under different brand names.
Morphine frequently pops up in the news because of accidental overdoses — lawsuits over fatal overdoses are generally directed at the pharmacies that made the drug or the clinics that prescribed it.
In 2008, KV Pharmaceutical Co. fired then-CEO and chairman Marc Hermelin for failing to take proper action to prevent the distribution of oversized versions of the company’s Ethex morphine pills, some of which had up to double the indicated dosage.
In 2011, after Hermelin pleaded guilty to violating drug-labeling laws, he was sentenced to 30 days in jail and forced to pay nearly $2 million in fines.
Morphine Abuse and Withdrawal
As with other opioid agonists, morphine carries a risk of abuse, misuse, and addiction, particularly for people with a personal or family history of substance abuse.
Addiction often results in various drug-seeking tactics, such as calling or visiting emergency rooms near the end of office hours, continually “losing” prescriptions, and “doctor shopping,” or trying to obtain additional prescriptions from other physicians.
Even if you don’t abuse morphine, you may become physically dependent on the drug and suffer withdrawal symptoms if you suddenly stop taking it.
Withdrawal symptoms include:
- Teary eyes and runny nose
- Irritability and anxiety
- Sweating and chills
- Restlessness, yawning, and difficulty falling asleep or staying asleep
- Back, muscle, or joint pain
- Nausea, vomiting, loss of appetite, diarrhea, and stomach cramps
- Quickened heartbeat and breathing
You shouldn’t use morphine if you have:
- A known sensitivity to morphine
- Respiratory depression (slowed breathing), bronchial asthma, or an abnormal amount of carbon dioxide in your body, and are in an unmonitored setting or without resuscitative equipment
- Paralytic ileus, an intestinal obstruction caused by paralyzed intestinal muscles
Morphine may cause respiratory depression. The risk of respiratory depression and other potentially fatal issues — including low blood pressure, profound sedation, coma, and death — increase when morphine is used in concert with central nervous system (CNS) depressants, such as sedatives, hypnotics, or other opioids.
The risk of respiratory depression with morphine is also greater for older people, people who are debilitated, or who already suffer from respiratory problems.
The oral solution of morphine (Roxanol) with the highest concentration (100 milligrams per 5 milliliters) should be taken only by people who are opioid tolerant or are used to the effects of opioids; the same is true for Avinza capsules containing 90 milligrams (mg) or more.
Morphine may cause severe low blood pressure in people who have low blood volume, anemia, or who were given general anesthetics or phenothiazines.
If you have a head injury or increased intracranial pressure, taking morphine may exaggerate the drug’s respiratory depressant effects. It may also further increase intracranial pressure.
Using morphine when you have bile or pancreatic duct diseases may cause sphincter spasms and reduce biliary and pancreatic secretions.
Tell your doctor if you have or have ever had severe kidney or liver problems, low blood pressure, Addison’s disease, hypothyroidism, prostate enlargement, seizures, difficulty swallowing, or urinary problems.
Pregnancy and Morphine
Morphine is an FDA Pregnancy Category C drug, meaning that animal studies have shown an “adverse” effect on the fetus, and harm to a woman’s fetus cannot be ruled out.
Because of this, the drug should only be given to pregnant women if the potential benefits outweigh the potential risk.
Morphine should also not be given to women before delivery, or to nursing mothers, as it both crosses the placenta and is excreted in breast milk, causing potential harm to newborn and breastfeeding infants.